Cryptosporidium sp. infection in solid organ transplant recipients: A systematic review and meta-analysis

Shahira Abdelaziz Ali Ahmed; Annalisa Quattrocchi; Panagiotis Karanis

doi:10.1080/20477724.2023.2290379

Cryptosporidium sp. infection in solid organ transplant recipients: A systematic review and meta-analysis

Pathog Glob Health. 2023 Dec 6:1-12. doi: 10.1080/20477724.2023.2290379. Online ahead of print.

Authors

Shahira Abdelaziz Ali Ahmed¹, Annalisa Quattrocchi², Panagiotis Karanis^{3

4}

Affiliations

¹ Department of Medical Parasitology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
² Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus.
³ Department of Basic and Clinical Sciences, University of Nicosia Medical School, Nicosia, Cyprus.
⁴ Centre of Antomy, University of Cologne, Medical Faculty and University Hospital, Cologne, Germany.

PMID: 38054456
DOI: 10.1080/20477724.2023.2290379

Abstract

(1) Background: Organ transplant recipients (OTRs) are vulnerable groups at risk of parasitic infections. This systematic review and meta-analysis aimed to evaluate the overall prevalence of Cryptosporidium sp. in OTRs and shed light on this potentially serious complication of organ transplantation. (2) Methods: We systematically searched studies on Cryptosporidium sp. infections in OTRs in four databases (Academia, PubMed, Scopus, and Science Direct). Random effects models were used to calculate pooled prevalence estimates with 95% confidence intervals (CIs). Sub-group and meta-regression analyses were conducted. A quality assessment of the included studies was also performed. (3) Results: Among 876 articles retrieved, 21 were included, accounting for 2,642 OTRs. Twenty studies were cross-sectional in design, of which seven reported data on a comparison group, and one was a retrospective cohort. The pooled prevalence of Cryptosporidium sp. in OTRs was 15% (95% CI: 7.4-24.6). Subgroup analysis revealed that the prevalence of Cryptosporidium sp. infection was higher in adults, symptomatics and developing countries and in studies using only non-molecular methods. However, substantial heterogeneity was reported. Low to moderate heterogeneity was observed in subgroups reporting lower prevalence Cryptosporidium sp. including children (5.8; 95% CI: 2.8-9.6), studies conducted in developed countries (5.8; 95% CI: 3.0-9.4) and studies using both molecular and non-molecular diagnostics (11.4; 95% CI: 6.4-17.4). The majority of the listed research reported low-medium quality scores. (4) Conclusion: Cryptosporidium sp. infection is a significant complication in OTRs with underreported prevalence. Preventive strategies to reduce the burden should include Cryptosporidium sp. routine screening for OTRs, particularly post-transplantation in patients with diarrhea. Additional well-designed research studies are required to determine the extent of the Cryptosporidium sp. burden in OTRs.

Keywords: Cryptosporidium sp.; Graft; Infection; Organ transplantation; Prevalence.

Publication types

Review